Lumbar Radiculopathy
(Sciatica/Herniated Disc/Pinched Nerve)

Pain in the low back that radiates to the hip, leg, and toes often times is caused by an irritation or injury to the nerves at the level of the spinal root near the lumbar spine. As vertebral disks age, they lose height and may begin to bulge or herniate.

Causes & Symptoms

Spondylosis is arthritis of the back and occurs with age. It is important to keep in mind that all these changes are "normal" and they occur in everyone. Though they are found in all people it is not known why some people have symptoms while others do not.

Pain from lumbar radiculopathy travels down the arm in the area of the involved nerve. It can occasionally cause weakness. Pain is usually described as sleeping, cramping, numbness, sharp, or pins and needles.

Evaluation & Treatment

Evaluation includes a detailed history and examination. Special maneuvers including strength, sensation, and reflexes testing are done. X-rays are evaluated to check the alignment of the bones. An MRI may be ordered to evaluate disk bulges and nerve root or spinal cord compression. In some cases electromyography and nerve conduction studies may be ordered evaluate the nerves further.

A majority of patients with cervical radiculopathy get better with time, medication, and physical therapy. Occasionally those with MRI findings that do not improve may benefit from spinal injections.

In those who do not find relief with the above treatment and who have MRI findings, surgical treatment may be recommended. Recovery from spinal surgery depends on the procedure performed and typically takes several months.